Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Communication
  • Published:

Dietary habits, lifestyle and cardiovascular risk factors in a clinically healthy Italian population: the ‘Florence’ diet is not Mediterranean

European Journal of Clinical Nutrition volume 59, pages 584–591 (2005)Cite this article

An Erratum to this article was published on 02 May 2005

Abstract

Objective:

To evaluate dietary habits and lifestyle of Italian subjects, to provide current data on adequacy of the nutritional guidelines and recommendations especially in relation to primary prevention of cardiovascular diseases and to assess the influence of dietary habits on lipid profile and homocysteine levels.

Design:

Cross-sectional.

Setting:

Population-based study.

Subjects:

A sample of 520 clinically healthy subjects (211 males, 309 females) with a mean age of 46 y, living in Florence area, Italy.

Interventions:

Dietary pattern was assessed by trained dietitians through a semiquantitative food questionnaire. Fasting blood samples were drawn for assessment of lipid profile, homocysteine and circulating vitamins.

Results:

Contribution from total fats was over 30% in about 70% of subjects and intake of saturated fatty acids (SFA) was above the recommended values in at least 40% of the study population. Furthermore, almost the whole (99.6%) population reported low intake of polyunsaturated fatty acids (PUFA). High levels of total cholesterol were present in over 40% of the study population, whereas abnormal values of LDL-cholesterol were observed in about 30%. High levels of homocysteine were found in 11.7% of the study population. An extremely high percentage of subjects reported low intake of vitamins, especially with regard to folic acid (89%), vitamin B6 (70.1%) and vitamin E (99.6%). In a multiple linear regression model, circulating levels of vitamin B12 and folic acid, and intake of alcohol and vitamin C resulted in being independently associated with homocysteine plasma levels.

Conclusions:

In a typical Mediterranean country, general outlines of Mediterranean diet are not completely followed, especially concerning total fats, SFA, PUFA and vitamins' intake.

Sponsorship:

Ministero della Salute (Italy) — ‘Progetto per la Salute e la Prevenzione di Malattia’ 2001–2003.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  • Ambring A, Friberg P, Axelsen M, Laffrenzen M, Taskinen MR, Basu S & Johansson M (2004): Effects of Mediterranean inspired diet on blood lipids, vascular function and oxidative stress in healthy subjects. Clin. Sci. 106, 519–525.

    Article  CAS  Google Scholar 

  • Ballesteros-Pomar MD, Rubio-Herrera MA, Gutierrez-Fuentes JA, Gomez-Gerique JA, Gomez-de-la-Camara A, Pascual O, Garate I, Montero R, Campina S & the DRECE study group (2000): Dietary habits and cardiovascular risk in the Spanish population: the DRECE study (I). Diet and cardiovascular events risk in Spain. Ann. Nutr. Metab. 44, 108–114.

    Article  CAS  Google Scholar 

  • Barbagallo CM, Cavera G, Sapienza M, Noto D, Cefalù AB, Polizzi F, Onorato F, Rini GB, Di Fede G, Pagano M, Montalto G, Rizzo M, Descovich GC, Notarbartolo A & Averna MR (2002): Nutritional characteristics of a rural southern Italy population: The Ventimiglia di Sicilia Project. J. Am. Coll. Nutr. 21, 523–529.

    Article  Google Scholar 

  • Bongard V, Ruidavets JB, Dallongeville J, Simon C, Amouyel P, Arveiler D, Ducimetiere P & Ferrieres J (2004): Nutritional intakes of 1072 French free-living men with and without diagnosed cardiovascular risk factors. Eur. J. Clin. Nutr. 58, 787–795.

    Article  CAS  Google Scholar 

  • Caggiula AW & Mustad VA (1997): Effects of dietary fat and fatty acids on coronary artery disease risk and total and lipoprotein cholesterol concentrations: epidemiologic studies. Am. J. Clin. Nutr. 65 (Suppl), 159–610.

    Google Scholar 

  • Capita R & Alonso-Calleja C (2003): Intake of nutrients associated with an increased risk of cardiovascular disease in a Spanish population. Int. J. Food Sci. Nutr. 54, 57–75.

    Article  CAS  Google Scholar 

  • Cattaneo M, Lombardi R, Lecchi A, Bucciarelli P & Mannucci PM (2001): Low plasma levels of vitamin B6 are independently associated with a heightened risk of deep-vein thrombosis. Circulation 104, 2442–2446.

    Article  CAS  Google Scholar 

  • Celi F, Bini V, De Giorgi G, Molinari D, Faraoni F, Di Stefano G, Bacosi ML, Berioli MG, Contessa G & Falorni A (2003): Epidemiology of overweight and obesity among school children and adolescent in three provinces of central Italy, 1993–2001: study of potential influencing variables. Eur. J. Clin. Nutr. 57, 1045–1051.

    Article  CAS  Google Scholar 

  • Correa Leite ML, Nicolosi A, Cristina S, Hauser WA, Pugliese P & Nappi G (2003): Dietary and nutritional patterns in an elderly rural population in Northern and Southern Italy: (I). A cluster analysis of food consumption. Eur. J. Clin. Nutr. 57, 1514–1521.

    Article  CAS  Google Scholar 

  • De Backer, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, Ebrahim S, Faergeman O, Graham I, Mancia G, Manger Cats V, Orth-Gomer K, Perk J, Pyorala K, Rodicio JL, Sans S, Sansoy V, Sechtem U, Silber S, Thomsen T & Wood D (2003): European guidelines on cardiovascular disease prevention in clinical practice. Eur. Heart J. 24, 1601–1610.

    Article  Google Scholar 

  • Dierkes J, Jeckel A, Ambrosch A, Westphal S, Luley C & Boeing H (2001): Factors explaining the difference of total homocysteine between men and women in the European Investigation Into Cancer and Nutrition Potsdam study. Metabolism 50, 640–645.

    Article  CAS  Google Scholar 

  • ESH/ESC (2003): Practice guidelines for primary care physicians: 2003 ESH/ESC Hypertension guidelines. ESH/ESC hypertension guidelines committee (2003). J. Hypertens. 21, 1779–1786.

  • European Heart Network. Food, Nutrition and Cardiovascular Disease Prevention in the European Region: Challenges for the New Millenium. (World Wide Web URL:http://www.ehnheart.org).

  • Fairfield KM & Fletcher RH (2002): Vitamins for chronic disease prevention in adults. JAMA 287, 3116–3126.

    Article  CAS  Google Scholar 

  • Ferro-Luzzi A, Strazzullo P, Scaccini C, Siani A, Sette S, Mariani MA, Mastranzo P, Dougherty RM, Iacono JM & Mancini M (1984): Changing the mediterranean diet: effects on blood lipids. Am. J. Clin. Nutr. 40, 1027–1037.

    Article  CAS  Google Scholar 

  • Fidanza F, Gentile MG & Porrini M (1995): A self-administered semiquantitative food-frequency questionnaire with optical reading and its concurrent validation. Eur. J. Epidemiol. 11, 163–170.

    Article  CAS  Google Scholar 

  • Giampaoli S, Vannuzzo D & on behalf of the Research Group of The Italian Cardiovascular Surveillance (2003): Italian atlas of cardiovscular diseases. Ital. Heart J. 4 (Suppl), 9–121.

    Google Scholar 

  • Gissi Prevenzione Investigators (1999): Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the Gissi Prevenzione trial. Lancet 354, 447–453.

  • Hankey GJ & Eikelboom JW (1999): Homocysteine and vascular disease. Lancet 354, 407–413.

    Article  CAS  Google Scholar 

  • Hu FB, Manson JE & Willett WC (2001): Types of dietary fat and risk of coronary heart disease: a critical review. J. Am. Coll. Nutr. 20, 5–19.

    Article  Google Scholar 

  • Kafatos A, Verhagen H, Moschandreas J, Apostolaki I & van Westerop JJM (2000): Mediterranean diet of Crete: foods and nutrient content. J. Am. Diet. Assoc. 100, 1487–1493.

    Article  CAS  Google Scholar 

  • Karamanos B, Thanopoulou A, Angelico F, Assaad-Khalil S, Barbato A, Del Ben M, Dimitrijevic-Sreckovic V, Djordjevic P, Gallotti C, Katsilambros N, Migdalis I, Mrabet M, Petkova M, Roussi D & Tenconi MT (2002): Nutritional habits in the Mediterranean basin. The macronutrient composition of diet and its relation with the traditional Mediterranean diet. Multi-centre study of the Mediterranean Group for the Study of Diabetes (MGSD). Eur. J. Clin. Nutr. 56, 983–991.

    Article  CAS  Google Scholar 

  • Keys A (1974): Coronary heart disease in seven countries. Circulation 41 (Suppl), 1–211.

    Google Scholar 

  • Keys A (1995): Mediterranean diet and public health: personal reflections. Am. J. Clin. Nutr. 61 (Suppl), 1321–1323.

    Article  Google Scholar 

  • Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordevic BS, Dontas AS, Fidanza F, Keys MH, Kromhout D, Nedeljkovic S, Punsar S, Seccareccia F & Toshima H (1986): The diet and 15-year death rate in the seven countries study. Am. J. Epidemiol. 124, 903–915.

    Article  CAS  Google Scholar 

  • Kromhout D, Bosschieter EB & de Lezenne Coulander C (1985): The inverse relation between fish consumption and 20 year mortality from coronary heart disease. N. Engl. J. Med. 312, 1205–1209.

    Article  CAS  Google Scholar 

  • Kromhout D, Menotti A, Blowmberg B, Aravanis C, Blackburn H, Buzina R, Dontas AS, Fidanza F, Giampaoli S, Jansen A, Karvonen M, Katan M, Nissinen A, Nedeljkovic S, Pekkanen J, Pekkarinen M, Punsar S, Rasanen L, Simic B & Toshima M (1995): Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study. Prev. Med. 24, 308–315.

    Article  CAS  Google Scholar 

  • Laurenzi M, Stamler R, Trevisan M, Dyer A & Stamler J (1989): Is Italy losing the ‘Mediterranean advantage?’. Report on the Gubbio population study: cardiovascular risk factors at baseline. Gubbio Collaborative Study Group. Prev. Med. 18, 35–44.

    Article  CAS  Google Scholar 

  • Masala G, Assedi M, Saieva C, Salvini S, Cordopatri G, Ermini I, del Carmen Martinez M, Tanzini D, Zacchi S, Ceroti M & Palli D (2003): The Florence city sample: dietary and life-style habits of a representative sample of adult residents. A comparison with the EPIC-Florence volunteers. Tumori 89, 636–645.

    Article  Google Scholar 

  • Pereira MA, O'Reilly E, Augustsson K, Fraser GE, Goldbourt U, Heitmann BL, Hallmans G, Knekt P, Liu S, Pietinen P, Spiegelman D, Stevens J, Virtamo J, Willett WC & Ascherio A (2004): Dietary fiber and risk of coronary heart disease. Arch. Intern. Med. 164, 370–376.

    Article  Google Scholar 

  • Reports of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (2003): Diabetes Care 26 (Suppl), 5–20.

  • Rimm EB, Willet WC, Hu FB, Sampson L, Colditz GA, Manson JE, Hennekens C & Stampfer MJ (1998): Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 279, 359–364.

    Article  CAS  Google Scholar 

  • Robinson K, Arheart K, Refsum H, Brattstrom L, Boers G, Ueland P, Rubba P, Palma-Reis R, Meleady R, Daly L, Witteman J & Graham I (1998): Low circulating folate and vitamin B6 concentrations: risk factors for stroke, peripheral vascular disease, and coronary artery disease. European COMAC group. Circulation 97, 437–443.

    Article  CAS  Google Scholar 

  • Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D'Agostino RB, Wilson PWF & Wolf PA (2002): Plasma homocysteine as a risk factor for dementia and alzheimer's disease. N. Engl. J. Med. 346, 476–484.

    Article  CAS  Google Scholar 

  • Sesso HD, Paffenbarger RS & Lee IM (2000): Physical activity and coronary heart disease in men: The Harvard Alumni Health Study. Circulation 102, 975–980.

    Article  CAS  Google Scholar 

  • Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adult (Adult Treatment Panel III (2002): Final report. Circulation 106, 3143–3421.

  • Tur JA, Romaguera D & Pons A (2004): Food consumption patterns in a Mediterranean region: does the Mediterranean diet still exist? Ann. Nutr. Metab. 48, 193–201.

    Article  CAS  Google Scholar 

  • van Meurs JBJ, Dhonukshe-Rutten RAM, Plujim SMF, van der Klift M, de Jonge R, Lindemans J, de Groot L, Hofman A, Witteman JCM, van Leeuwen J, Breteler MMB, Lips P, Pols HAP & Uitterlinden AG (2004): Homocysteine levels and the risk of osteoporotic fracture. N. Engl. J. Med. 350, 2033–2041.

    Article  CAS  Google Scholar 

  • Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E & Trichopoulou D (1995): Mediterranean diet pyramid: a cultural model for healthy eating. Am. J. Clin. Nutr. 61 (Suppl), 1402–1406.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Florence, Italy

    F Sofi, S Vecchio, G Giuliani, R Marcucci, A M Gori, S Fedi, R Abbate & G F Gensini

  2. Dipartimento del Cuore e dei Vasi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    F Sofi, S Vecchio, G Giuliani, R Marcucci, A M Gori, S Fedi, R Abbate & G F Gensini

  3. Department of Clinical Pathophysiology, Nutrition Centre and Gastroenterology Unit, University of Florence, Florence, Italy

    A Casini & C Surrenti

  4. Dipartimento di Specialità Medico-Chirurgiche, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    A Casini & C Surrenti

  5. Centro Interdipartimentale di Ricerca per la Valorizzazione degli Alimenti (CeRA), University of Florence, Florence, Italy

    F Sofi, R Marcucci, A M Gori, S Fedi, A Casini, C Surrenti, R Abbate & G F Gensini

Authors
  1. F Sofi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Vecchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G Giuliani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R Marcucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A M Gori
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Fedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A Casini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C Surrenti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. R Abbate
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. G F Gensini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F Sofi.

Additional information

Guarantors: F Sofi, R Abbate and A Casini.

Contributors: FS designed the protocol of the study, did statistical analysis and wrote the manuscript. RA, GFG, AC and CS designed the protocol of the study and supervised the execution of the study and of the manuscript. SV, GG and FM organised the field work. RM and AMG supervised the execution of the study. SF did laboratory analyses.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sofi, F., Vecchio, S., Giuliani, G. et al. Dietary habits, lifestyle and cardiovascular risk factors in a clinically healthy Italian population: the ‘Florence’ diet is not Mediterranean. Eur J Clin Nutr 59, 584–591 (2005). https://doi.org/10.1038/sj.ejcn.1602112

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1602112

Keywords

This article is cited by

Search

Advanced search

Quick links